THE PATIENT-CENTERED OUTCOMES OF CRITICAL CARE - WHAT ARE THEY AND HOW SHOULD THEY BE USED

There is a growing recognition that clinical research needs to define and focus on the outcomes of medical care which are important to patie nts. The outcomes important to patients have been coined ''patient-cen tered'' outcomes. In the past, clinical research in critical care medi cine has tended to focus on survival and physiologic impairment, and n ot as much on outcomes such as functional status and quality of life. While survival and physiologic impairment are the appropriate outcomes in some settings, we also need to address important questions about t he effect of critical care medicine on other outcomes. The goals of th is article are to describe the patient-centered outcomes of critical c are research, to identify important issues and pitfalls in measuring t hese outcomes, and to identify the situations in which these outcomes may be more or less important. The outcomes addressed include: mortali ty, patient-assessed outcomes (quality of life, functional status, and health status), physiologic parameters, process-of-care measures, and quality of death.